Perceived Stress and Disordered Eating Behaviors in Emerging Adulthood: A Multidimensional Pilot Study of Dietary and Genetic Factors.

BACKGROUND: Subclinical disordered eating behaviors (DEBs) are common among young women and are thought to result from complex interactions between psychological, dietary, and genetic factors. While chronic stress and unhealthy dietary habits have been implicated in the development of DEBs, the independent and interactive contributions of perceived stress, added sugar intake, and genetic susceptibility remain insufficiently understood. This pilot study investigated these associations using a two-stage case-control design. METHODS: A total of 100 female university students (18-27 years) completed the Dutch Eating Behavior Questionnaire (DEBQ) during the first stage of the study. Based on DEBQ scores, 20 participants with the highest risk of DEBs and 20 with the lowest risk were selected for the second stage, forming case and control groups. Perceived stress was assessed using the Perceived Stress Scale (PSS-14), and added sugar intake was estimated using a semi-quantitative food frequency questionnaire (FFQ). Participants were also genotyped for four candidate polymorphisms (5-HTTLPR, rs6295, rs6265, and rs1800497). Group differences, correlation analyses, binary logistic regression models adjusted for BMI, and gene-environment interaction analyses were performed. RESULTS: Perceived stress emerged as the strongest and most consistent predictor of belonging to the upper DEBQ quintile, with each one-point increase on the PSS-14 associated with a 44% increase in the odds of high-risk status after adjustment for BMI (OR = 1.44; 95% CI: 1.120-1.853; p = 0.004). Added sugar consumption did not withstand correction for multiple comparisons (p = 0.030, Bonferroni-adjusted α = 0.025). No significant main effects or gene-environment interactions were detected for any of the investigated polymorphisms or the cumulative genetic risk score. CONCLUSIONS: These preliminary findings highlight perceived stress as the important modifiable risk factor for subclinical disordered eating behaviors in young women, suggesting that stress-reduction and emotional regulation interventions may be more effective than dietary approaches in this population. However, the lack of significant associations for the genetic variants studied should be interpreted with caution given the limited sample size and statistical power. Replication in larger, longitudinal cohorts is warranted to confirm these findings and explore developmental trajectories.